Accuracy of 3-T MR Arthrography Versus Conventional 3-T MRI of Elbow Tendons and Ligaments Compared With Surgery

OBJECTIVE. MR arthrography of the elbow has been found to be useful in the diagnosis of full-versus partial-thickness tears of the collateral ligaments. This article assesses the accuracy of 3-T MR arthrography of the elbow versus conventional 3-T MRI of the elbow, compared with surgery. MATERIALS AND METHODS. Seventy-nine consecutive conventional elbow MRI and MR arthrography examinations performed on the same patients who went on to surgery were retrospectively read in consensus by two musculoskeletal radiologists. Full-or partial-thickness tears of the collateral ligaments and full-thickness tears of the extensor and flexor tendons were assessed. RESULTS. In 54 patients, the diagnoses made on MRI and MR arthrogram examinations were the same. In 16 patients, MR arthrogram examinations revealed additional findings that were not clearly seen on conventional MRI examinations. There were six full-thickness extensor tendon tears, seven radial collateral ligament tears, and three partial-thickness ulnar collateral ligament tears seen on MR arthrography that were not well seen on conventional MRI. In nine patients, MR arthrogram showed ligaments and tendons to be intact that appeared torn on conventional MRI. There were six ulnar collateral ligaments and three common flexor tendons found to be intact on MR arthrography examination that appeared to be torn on conventional MRI. All MR arthrography findings were confirmed at surgery. CONCLUSION. MR arthrography is more accurate than conventional MRI of the elbow at 3 T. In 16 cases, MR arthrography showed tendons and ligaments to be torn that appeared intact on conventional MRI. In nine cases, MR arthrography showed intact tendons and ligaments that appeared to be torn on conventional MRI. These nine cases are most likely the result of the tears healing, with fibrous tissue allowing the tendon and ligament tissues to coapt.